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SolaireSolstice

SolaireSolstice BSN, RN

Adult Oncology
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SolaireSolstice is a BSN, RN and specializes in Adult Oncology.

SolaireSolstice's Latest Activity

  1. SolaireSolstice

    Please Explain the Certs.

    Do you have your CPR certification? That's BLS, basic life support. ACLS is advanced. It is required in my hospital for ICU, ER, OR, L&D, and I believe telemetry. There are a ton of certifications available for nurses and which ones you "need" are depending on what area you wish to work. I only hold BLS. I am also chemo/biotherapy certified. You wouldn't need that if you did orthopedics. I'm thinking of going for wound/ostomy certification too. Wouldn't be required, but would be beneficial. Many certifications require you to already be a nurse before starting, and many others require an RN.
  2. SolaireSolstice

    bariatric bed "too big"

    The bariatric beds we have can be "broken down" to fit through the doorways. They simply expand along each side. Was this an issue with the bed not being able to fit through the doorway, in which it was an issue of lack of equipment teaching? Or did the room not accomodate the bed? Which I cannot fathom how small the room must be to not fit a bariatric bed. We had an issue once where the patient, on a bariatric bed, needed to go down in the bed for a procedure. We broke down the bed to fit through our doorway, but somehow, halfway through the doorway, the bed frame popped back wide and the bed was hoplessly stuck in the door frame, with the patient on the bed. Was a stupid hour long issue that had our superviser demanding maintenance to remove the doorframe. We ended up transferring the patient lengthways onto another bed, took the headboard off one and the footboard off the other. Took 7 of us. Once she was off it, it was easy to manipulate the bed to get it free. Reminded me of that puzzle of a truck stuck under an overpass and the little boy says to "let the air out of the tires".
  3. SolaireSolstice

    Safety while on BT

    Yes, you can stop a blood transfusion. As long as you get the transfusion into the pt within the 4 hr period, then it's fine. While I *have* kinked the line above the port and flushed, put in med, flushed again, I think it's safer to stop the transfusion, disconnect, flush, administer, flush, reconnect and re-start. Whether to hold the med until after its done depends on the med for me. What's it for? Do they need it NOW? What would change if it were held until the transfusion is done? A PRN pain med? I try to medicate before transfusion, but if breakthrough pain happens, then there you are. Do I make the pt wait 2 more hours? No, that would be mean. I've had a peripheral line infiltrate during a transfusion. What to do? Well, you stop the transfusion, start a new line and restart. However, it is best to follow your facilities policies.
  4. SolaireSolstice

    Late name change. Worried.

    I don't see anything that says you have to change it within ten days of the name change. I see that it will take THEM ten days upon receipt of the name change information. It would be ridiculous to require notification within ten days of a name change. I'd like to see where you got the information "on your own". But if you are that concerned, you can call them or e-mail.
  5. SolaireSolstice

    Cover your mouth....the right way!

    I had a huge argument with my sister (a teacher) about the coughing in the hands vs the elbow thing. I voted elbow. She says hands because then "they get washed". I said "only if you wash them".
  6. SolaireSolstice

    has anyone ever discharged a patient with their IV still in?

    I forgot to deaccess a mediport once. Pt was being transferred to a SNF via transport service on a Friday, and was going for OP chemo on Monday. The SNF had no idea how to deaccess, so I called the MD who said to leave the mediport accessed and that way they wouldn't have to reaccess him on Monday. Thank God. The SNF was all the way on the other side of town and I really didn't want him to have to get transported back just to deaccess it.
  7. SolaireSolstice

    What Is Your Most Gross, Yucky, Disgusting Nursing Horror Story?

    Ok, this was totally my bad. The other day I was helping my confused patient clean up after the bedside commode, another nurse was holding him up while I wiped him with those wipes that can't be flushed. I wiped him and dropped the dirty wipe into the big black hole right where my trashcan had been last time I did this 2 hours before, and oops, that wasn't my trashcan. It had been moved, and this was... it was his wife's big black leather purse! Luckily I had folded it so the dirty side wasn't exposed. Me and the other nurse just lost it, giggling, tears running down our faces while we got him back into bed. Ah, a moment of levitity does the heart good after a really bad day.
  8. SolaireSolstice

    What Is Your Most Gross, Yucky, Disgusting Nursing Horror Story?

    This weekend I had a patient who needed to be manually irrigated "as needed". After 4 hours of no output, I bladder scanned and went to manually irrigate (my first time doing this). I got instructions from a more experienced nurse first, then went in and explained to the family what I was going to do. They elected to stay in the room. (Pt was sedated). I don't know about you, but when I see a nurse coming in in full PPE with goggles on and a 60 cc syringe and she explains that she is going to attach this to my male relative's foley to try and unblock it, I'd be singing "Feet don't fail me now." I got my syringe ready and went to attach it, but when I went to push the syringe in I got it caught on the drape and sprayed a bit of the saline solution. I think I got the daughter a bit. I explained it was just saline solution, that it wasn't even on the line yet and did they still want to stay? (you can see where this is going I'm sure.) I got the syringe attached and was pushing and pulling on the syringe plunger a little bit at a time, when suddenly the "fluid" backsprayed all over my face. The wife was sitting RIGHT behind me. It was probably only 15 cc of fluid based on how much I had in the syringe still. *A refreshing spritz of saline solution with a light hint of stale urine.* Bath and Body Works, you have competition. My only consolation was they had been dutifully warned, I took the brunt of the spray, my mouth was closed, and I hadn't cleared the blockage. But it was still fluid from a foley that had previously had urine running through it. I quietly and as low profile as possible wiped my face with a towel I had there at the ready. The wife said nothing (maybe it didn't get her? I can only hope. I did have a drape). Once I was finished I was able to go wash my face (read: soak my head for 10 minutes in very hot water). I smelled urine for the rest of the day although my co-workers told me they didn't smell anything, once they got their breath back from laughing. I've taken 3 showers since I've gotten home last night.
  9. SolaireSolstice

    Birth Control Pill Question

    These are questions you should ask the person prescribing your birth control. This site cannot give medical advice.
  10. SolaireSolstice

    Another Vent...About a Frequent Faller!

    There's "bed in the lowest position", and then there's the "low bed". A low bed at my hosptal is a bed that lowers all the way to the floor. If a patient rolled out of a low bed, the fall would be about 5 inches, whereas a fall from a regular bed at lowest position, especially when reaching for something, could be about 2 feet, onto their head. Which is your patient on?
  11. SolaireSolstice

    How do you handle patients/relatives?

    I'm probably not the best one to be answering this, because I tend to be rather blunt, but no one else has replied, and I too have had these issues with family. However, I don't usually say it with a smile. I just say the issue straight and to the point. "Just the facts, ma'am." However, I have never (knocking on wood) had someone complain that I was rude. "She is receiving *whatever treatment* for *whatever reason* and per *whatever MD's* orders. I would be happy to pass the concern over to the MD during rounds." Sometimes I will ask directly "What is it that you are concerned about *this treatment*?" and if it's something I can answer I do so, or find the information to help them. And if the patient voices the refusal to me directly, I will remove *whatever is offending them* and document. Patients are allowed to refuse treatment, and I always state this. But until the patient tells me they don't want it, or it's not safe, or the MD orders it DCd, I am to continue *the treatment*, unless that family member is medical POA and the patient is unable to voice their wishes. The ones who puff up and state they are *whatever medical profession* will understand your need to document about patient's refusing treatment, unless they are not actually that profession. Which has happened more often than I care to comment. A simple example: A patient had come to us from a stay in ICU with a peripheral still intact and within date. The peripheral was not needed for current treatment, all medications were po, but still flushed well and after a day even still had blood return. A family member asked why the pt still had "that IV" and why didn't I remove it after I had checked it's viability. I said I would check if we needed it, but that it was still a good IV. I checked with the MD (he happened to be at the desk) and asked how he felt about me removing the peripheral. He told me and I explained (speaking both to the fully alert and oriented pt and the family member) that while the patient was better and no longer needed the higher level of care that the ICU offered, the pt was still medically fragile, and if an emergency happened, starting an IV would take needed time and definitely an additional hole, if not more since she was a difficult stick. (Actually what the MD answered was "if she crashes again, how fast could you start an IV on her?" I didn't state it in quite those terms to the pt.) "This is a good IV, still within date. Until it's no longer viable, it's safer to keep it intact." The patient understood, and once the pt understood, I no longer needed to discuss the matter w/ the family.
  12. SolaireSolstice

    What Is Your Most Gross, Yucky, Disgusting Nursing Horror Story?

    This weekend I took care of a patient who had been transferred in to my unit after a round in the ICU. He hadn't had a BM since admission 4 days previous, and he felt the need for one after transfer, thank god. NP, got him a BSC, got him settled. He was embarressed about using a BSC, had been ambulatory and self-sufficient prior, and kept apologizing. About 30 minutes later he was done, and his enormous but soft BM promptly clogged the toliet when I went to flush it. It just sat, like I had sealed the hole with a partially deflated volley ball. And this was in a semi-private! Since he was so embarressed already, I tried not to call any attention to the fact that I couldn't get this... thing to go down. I tried to break it apart a bit, I swear I was wearing gloves, and I used a tongue depressor, but it was sticky and just a thick mass, like trying to carve up a fruitcake with a toothpick. I covered the stuff with a light layer of toliet paper, closed the door, and called maintenance. The other patient in the room thankfully was discharged before he needed to use the bathroom again. Note to self, next time use the water to soften it up before I dump it down.
  13. SolaireSolstice

    Neutropenic pt W/other isoloation pt

    Ok, I get it. Totally misunderstood before, and now I can't edit. Yes, in our hospital we take care of patients that are neutropenic and other isolation patients at the same time. There doesn't seem to be much cross over from infection at all. Universal precautions cover the basic issues, and contact precautions cover the rest. We use disposable gowns on contact precaution which are kept outside those patient rooms, they are discarded when you leave the room. Signs are posted outside those patients rooms. We have the alcohol scrub on the wall between every couple of rooms, and sinks in the middle of each hallway. The issues that you cite as being the reasons why to have seperate staff are issues that should be addressed regardless. Staff not washing hands? Why not? Cleaning equpiment? Put the correct wipes on a dedicated machine and keep that machine in the isolation room. Curtains? We use blinds, and that seems like something housekeeping should address. And floors are gross, so the shoes is a non-starter. Unless you are changing shoes when you walk into the "reverse isolation" side, you are tracking nasty stuff in there anyway from outside.
  14. SolaireSolstice

    Neutropenic pt W/other isoloation pt

    Well, our Onc and ID MDs would be flipping out and would start admitting their patients to other hopitals. We isolate our neutropenic patients alone, whether on contact precautions or not. One of our Onc MDs doesn't even like us to keep patients delivered flowers at the nurse's station; he would be apoplectic if we tried housing contact precautions with neutropenic patients. The ID MDs are a bit more pragmatic, especially when it comes to the MDROs. As long as we keep our neutropenic patients away from the ones w/ contact precautions and we wash our hands, they don't stress too much. Contact precation patient are *usually* isolated alone on our floor, but of 28 rms, 24 of them are privates anyway, so if anything, we usually end up short semi privates rather than privates anyway. Trying to play musical beds to get 2 semis in the same room w/ the same precautions would be silly. Our hospital has an infectious disease dept, which is actually part of our risk management dept. They make sure we have the correct isolation precautions in place on these types of patients and lately have been in charge of making sure those employees that didn't get the flu shot are wearing their masks. They seem *bored* to say the least, and could use something more interesting to do. Check and see if your hospital has a dept like this and bring up your concerns to them?
  15. SolaireSolstice

    Conflict of interest, nursing family

    A family member is going to be admitted for care to my unit. Do I just tell my charge nurse to be sure not to assign me to their care? If they mistakenly assign me, do I just ask for re-assignment? This won't be a big issue, right?
  16. SolaireSolstice

    What are the worst call in excuses you've heard?

    I called in once because I had gotten skunked, twice. And I had to wait for the animal control people to come capture the skunk after my dogs had "mostly" killed it because this had happened in the daylight hours (which is not usual for skunks) to make sure it didn't have rabies. Our case mananger's dog had gotten skunked, and she came to work that morning and her boss SENT her home because she smelled so bad.